37-210
Tratamiento quirúrgico de fracturas toracolumbares por vía posterior con instrumentación y fusión bisegmentaria
Surgical management of toracolumbar fractures with posterior fusion
A. BAÑOS CLEMENTE, J. RAMÍREZ VILLAESCUSA, J. MARTÍNEZ CASTROVERDE PÉREZ, J. MARTÍNEZ ARNÁIZ, E. PORTERO MARTÍNEZ, J.M. ANDRÉS GONZÁLEZ. UNIDAD DE COLUMNA. SERVICIO DE TRAUMATOLOGÍA Y CIRUGÍA ORTOPÉDICA. COMPLEJO HOSPITALARIO DE ALBACETE.
Recepción:
16/09/2008
Aceptación:
16/09/2008
Publicación:
16/09/2008
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Resumen (ES)
We evaluate retrospectively the clinical, radiologic
and funcional outcomes of patients admitted to our hospital
with unstable vertebral fractures with or without neurologic
lesion treated with posterior fusion and transpedicular instrumentation
of the upper and lower segment to the fractured
vertebra. Thirty 30 patients with unstable vertebral fracture of
the thoracolumbar segment surgically managed between
January 1993 and December 2000 are studied. The surgical
approach was posterior in all cases, with posterolateral
fusion with autologous corticocancellous graft. In 8 patients
the fractured vertebra was also included. In two cases with
neurologic impairment, a posterolateral decompression and
laminectomy were associated. The Smiley-Webster score
was used for the clinical and functional outcome with excellent
results in 22 patients. The preoperative sagittal index
was 14,4 degrees and improved to 4,2 degrees after surgery.
The mean of vertebral body height was 46% preoperatively,
and 78 % postoperatively. The results obtained with this fixation
are similar to other devices which require longer fusion
and instrumentation or a second procedure to remove the
hardware.
and funcional outcomes of patients admitted to our hospital
with unstable vertebral fractures with or without neurologic
lesion treated with posterior fusion and transpedicular instrumentation
of the upper and lower segment to the fractured
vertebra. Thirty 30 patients with unstable vertebral fracture of
the thoracolumbar segment surgically managed between
January 1993 and December 2000 are studied. The surgical
approach was posterior in all cases, with posterolateral
fusion with autologous corticocancellous graft. In 8 patients
the fractured vertebra was also included. In two cases with
neurologic impairment, a posterolateral decompression and
laminectomy were associated. The Smiley-Webster score
was used for the clinical and functional outcome with excellent
results in 22 patients. The preoperative sagittal index
was 14,4 degrees and improved to 4,2 degrees after surgery.
The mean of vertebral body height was 46% preoperatively,
and 78 % postoperatively. The results obtained with this fixation
are similar to other devices which require longer fusion
and instrumentation or a second procedure to remove the
hardware.
Palabras clave (ES):
Operatorio
Instrumentación
Fijación
Fusión
Posterior
Vía
Abordaje
Tratamiento
Torácica
Toracolumbar
Lumbar
Columna
Raquis
Quirúrgico
Resumen (EN)
We evaluate retrospectively the clinical, radiologic
and funcional outcomes of patients admitted to our hospital
with unstable vertebral fractures with or without neurologic
lesion treated with posterior fusion and transpedicular instrumentation
of the upper and lower segment to the fractured
vertebra. Thirty 30 patients with unstable vertebral fracture of
the thoracolumbar segment surgically managed between
January 1993 and December 2000 are studied. The surgical
approach was posterior in all cases, with posterolateral
fusion with autologous corticocancellous graft. In 8 patients
the fractured vertebra was also included. In two cases with
neurologic impairment, a posterolateral decompression and
laminectomy were associated. The Smiley-Webster score
was used for the clinical and functional outcome with excellent
results in 22 patients. The preoperative sagittal index
was 14,4 degrees and improved to 4,2 degrees after surgery.
The mean of vertebral body height was 46% preoperatively,
and 78 % postoperatively. The results obtained with this fixation
are similar to other devices which require longer fusion
and instrumentation or a second procedure to remove the
hardware.
and funcional outcomes of patients admitted to our hospital
with unstable vertebral fractures with or without neurologic
lesion treated with posterior fusion and transpedicular instrumentation
of the upper and lower segment to the fractured
vertebra. Thirty 30 patients with unstable vertebral fracture of
the thoracolumbar segment surgically managed between
January 1993 and December 2000 are studied. The surgical
approach was posterior in all cases, with posterolateral
fusion with autologous corticocancellous graft. In 8 patients
the fractured vertebra was also included. In two cases with
neurologic impairment, a posterolateral decompression and
laminectomy were associated. The Smiley-Webster score
was used for the clinical and functional outcome with excellent
results in 22 patients. The preoperative sagittal index
was 14,4 degrees and improved to 4,2 degrees after surgery.
The mean of vertebral body height was 46% preoperatively,
and 78 % postoperatively. The results obtained with this fixation
are similar to other devices which require longer fusion
and instrumentation or a second procedure to remove the
hardware.
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